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At least 1,369 records · Page 76Linked to original sources
PubMed2001

Repetitive transcranial magnetic stimulation to SMA worsens complex movements in Parkinson's disease.

OBJECTIVES: To evaluate the therapeutic potential of repetitive transcranial magnetic stimulation (rTMS) for Parkinson's disease (PD) by delivering stimulation at higher intensity and frequency over longer time than in previous research. Promising beneficial effects on movement during or after rTMS have been reported. METHODS: Ten patients with idiopathic PD were enrolled in a randomized crossover study comparing active versus sham rTMS to the supplementary motor area (SMA). Assessments included reaction and movement times (RT/MT), quantitative spiral analysis, timed motor performance tests, United Parkinson's Disease Rating Scale (UPDRS), patient self-report and guess as to stimulation condition. RESULTS: Two of 10 patients could not tolerate the protocol. Thirty to 45 min following stimulation, active rTMS as compared with sham stimulation worsened spiral drawing (P=0.001) and prolonged RT in the most affected limb (P=0.030). No other significant differences were detected. CONCLUSIONS: We sought clinically promising improvement in PD but found subclinical worsening of complex and preparatory movement following rTMS to SMA. These results raise safety concerns regarding the persistence of dysfunction induced by rTMS while supporting the value of rTMS as a research tool. Studies aimed at understanding basic mechanisms and timing of rTMS effects are needed.

Aged↗
PubMed1999

Abnormal contingent negative variation in writer's cramp.

OBJECTIVE: To investigate the physiological abnormality in writer's cramp, a focal dystonia which specifically affects writing. METHODS: We recorded brain potentials that precede hand and neck movements (contingent negative variation or CNV) in 11 patients and 11 age-matched normal subjects. A 1000 Hz tone burst (S1) was delivered to the right or left ear in random sequence, and 2 s after, a 2000 Hz tone burst (S2) was delivered to both ears simultaneously. For the response task to S2, the subjects were instructed to extend their fingers ipsilateral to the ear to which S1 was given in one experiment or to rotate the head to the side of the S1 presentation in another. All the patients had symptoms in the right hand only, and performed both tasks normally. CNV amplitudes were compared between normals and patients using unpaired t test. RESULTS: They showed normal CNV for neck movement but significantly decreased CNV amplitudes for movements both in the affected and unaffected hands. CONCLUSIONS: Our findings suggest that motor programming is specifically abnormal for the affected body part, including the asymptomatic contralateral limb, and that the clinical symptom may result from a deficient compensatory mechanism for abnormal motor programs or subroutines.

Adult↗
PubMed1982

Anticholinergics in adult-onset focal dystonia.

Anticholinergics are one of the most common treatments used in adult-onset focal dystonias although their general efficacy has not been proven. We have investigated the effects of intravenous administration of atropine, benztropine and chlorpheniramine, in comparison to normal saline, in 20 patients with adult-onset focal dystonias (spasmodic torticollis (9), cranial dystonia (6), writer's cramp (5), and have retrospectively reviewed the notes of 78 patients (spasmodic torticollis (38), cranial dystonia (25), writer's cramp (15), who had received chronic oral anticholinergic therapy in varying doses at some time in the past. Patients with spasmodic torticollis and writer's cramp showed no consistent change with any of the intravenous drugs, while the few with cranial dystonia who improved usually did so at the expense of drug-induced sedation. The natural variability of these disorders was evident in the response to normal saline, which caused changes in the scores for severity of the involuntary movements of 20% or more in some patients. Only 8 of the patients who had received chronic oral therapy obtained more than mild benefit, and in 3 of them this improvement was transient. We conclude that cholinergic mechanism are not of general or prime importance in the pathogenesis of adult-onset focal dystonias. However, each new patient warrants a trial of chronic oral anticholinergic therapy in view of the occasional useful responses obtained with these drugs.

Administration, Oral↗
PubMed2001

What can be learned from a lattice analysis of a laterality questionnaire?

In order to develop a genetic study of human laterality, we conducted an exploratory study concerning one aspect of this phenotype: lattice analysis was used to determine whether the structure of manual preference was the same for right- and left-handers. The study highlights the links between two sets - participants and actions - describing binary data, by ordering them "dually" along a "Galois lattice": participants were ordered according to subsets of actions for which they used only their writing hand, while actions were ordered according to sub-groups using their writing hand to perform them. The twelve item questionnaire of Annett was analysed in two samples of 94 adult right-hand and 31 left-hand writers. The items did not have the same categorical impact for the two groups of left- and right-hand writers. The behaviour of right-handers appeared globally more stereotyped. On the contrary, left-handed profiles were nearly all distinct. To explore these conclusions more thoroughly in the general population would certainly require greater samples. Nevertheless in both cases the observed structures were highly dimensional, a result that would grow stronger as the group sizes increase. Hence whereas some questionnaires purport to evaluate laterality along an unidimensional continuum, the present analysis questions such a strong assumption providing evidence to the contrary.

Adolescent↗
PubMed2003

Implementation of a computerized physician medication order entry system at the Academic Medical Centre in Amsterdam.

In the period 1997-2001 the Academic Medical Centre in Amsterdam implemented the computerized physician medication order entry (CPmOE) system Medicator. This article describes several important aspects of this program: technological architecture, features, implementation project, authentication and training, continuous support, human resource investments, route of prescription, logistics and administration. Furthermore important advantages and disadvantages of the CPmOE system are discussed. Advantages mainly concern patient safety and drug logistics, while disadvantages are related to access to a computer, user friendliness of the software and printer problems.

Academic Medical Centers↗
PubMed1990

Effects of motor programming on the power spectral density function of finger and wrist movements.

Power spectral density analysis was applied to the frequency content of the acceleration signal of pen movements in line drawing. The relative power in frequency bands between 1 and 32 Hz was measured as a function of motoric and anatomic task demands. Results showed a decrease of power at the lower frequencies (1-4 Hz) of the spectrum and an increase in the middle (9-12 Hz), with increasing motor demands. These findings evidence the inhibition of visual control and the disinhibition of physiological tremor under conditions of increased programming demands. Adductive movements displayed less power than abductive movements in the lower end of the spectrum, with a simultaneous increase at the higher frequencies. The relevance of the method for the measurement of neuromotor noise as a possible origin of delays in motor behavior is discussed.

Adult↗
PubMed1979

Why is telling right from left more difficult than telling above from below?

Adults take longer to judge the locations of horizontal stimuli than to judge the locations of vertical stimuli. In order to determine the source of this difficulty with the horizontal dimension, the congruity between the locations of stimuli and verbal descriptions was judged in a reaction time (RT) task. Because bilateral symmetry of the nervous system may be related to the difficulty with horizontal stimuli, this was varied by using right-handed, left-handed, and ambidextrous subjects. However, this variable produced no significant effects in the RT task. Horizontal stimuli took longer than vertical stimuli whether the verbal description was encoded before or during the RT periods, suggesting that label encoding is not the entire source of the effect. However, when the verbal labels were eliminated entirely by having subjects learn and use stimulus-letter pairs, horizontal stimuli did not take longer than vertical stimuli. This suggests that perception of the stimulus is not the cause of the difficulty. Together, the experiments indicated that comparing horizontal labels to stimuli is the largest source of the difficulty in telling right from left. Reasons why adults have such a problem were discussed.

Discrimination Learning↗
PubMed1978

Variations in cerebral organization as a function of handedness, hand posture in writing, and sex.

During the past century, it has become increasingly apparent that there is a great deal of variation in the direction and degree of cerebral lateralization, a plurality of people having language and related functions strongly specialized to the left hemisphere and visuospatial functions strongly specialized to the right, with substantial minorities manifesting various deviations from this pattern. In particular, in 35%-50% of sinistrals and 1%-10% of dextrals, the right hemisphere is specialized for linguistic skills, and in some unknown fraction of the two handedness groups, verbal and/or spatial abilities are, to varying extents, bilateralized. Levy (1973) suggested that the hand posture adopted during writing might be an index of the lateral relationship between the dominant writing hand and the language hemisphere, a normal posture indicating contralateral language specialization, and an inverted posture indicating ipsilateral language specialization. In the present investigation, two tachistoscopic tests of cerebral lateralization, one measuring spatial functions and one measuring verbal function, were administered to 73 subjects classified by handedness, hand posture during writing, and sex. Among both dextral and sinistral subjects with a normal writing posture, language and spatial functions were specialized to the contralateral and ipsilateral hemispheres, respectively, and lateral differentiation of the brain was strong. The reverse was seen in subjects having an inverted writing posture. In all groups, females were less laterally differentiated than males. In 70 out of 73 subjects, the direction of cerebral laterization was accurately predicted by handedness and hand posture. The 3 subjects (2 females and 1 male) who failed to manifest the predicted relations were all left-handers having an inverted hand posture . In this group, lateral differentiation was so weak that the reliability of the tachistoscopic tests was reduced, and we attribute these three predictive failures to this cause. Thus, almost all of the variation in the lateral organization of the brain was accounted for by handedness, hand posture, and sex.

Cerebral Cortex↗
PubMed1993

The time it takes elderly and young individuals to draw pictures and write words.

Twenty elderly and 20 young Ss drew pictures or wrote words for picture or word stimuli. Elderly Ss had slower response initiation than young Ss, especially when drawing. Beyond this, both age groups processed picture and word stimuli similarly. Elderly and young Ss exhibited equivalent latency increases for cross-modality trials (e.g., draw a picture given a word) over within-modality trials (e.g., draw a picture given a picture), regardless of stimulus or task modality. Strong support was found for a mathematical model of these results, which assumes age-related additive slowing for input and output subprocesses but age invariance for a cross-modality transfer subprocess. However, regressing elderly on young whole-condition latencies indicated general, multiplicative slowing: a discrepancy that questions the utility of the global Brinley plot procedure in revealing the nature of age-related slowing.

Adolescent↗
PubMed2003

How is emergent writing based on drawing? Analyses of children's products and their sorting by children and mothers.

Writing and drawing produced by children 28-53 months old were compared. Israeli and Dutch preschoolers were asked to draw and write, to classify their products as drawing and writing, and to decide what they had drawn or written. Israeli and Dutch mothers classified the products. Scores on a scale for writing composed of graphic, "writing-like," and symbolic schemes showed improvement with age. Recognition of drawings as drawings preceded recognition of writings as writings. Scores on writing and drawing were substantially correlated, even with age partialed out, suggesting (a) that when children start drawing objects referentially, they write by drawing "print" and (b) that progress in object drawing involves progress in drawing print, so that their writing becomes more writing-like. Children unable to communicate meaning by writing spontaneously resort to drawing-like devices, indicating the primacy of drawing as a representational-communicative system.

Art↗
PubMed1994

How and why do the two cerebral hemispheres interact?

Research on the anatomical bases of interhemispheric interaction, including individual differences in corpus callosum (CC) anatomy, is reviewed. These anatomical findings form the basis for the discussion of two major themes. The first considers interhemispheric transfer time (IHTT) and related issues. These include varieties of IHTT and possible directional asymmetries of IHTT. Evidence suggests that pathological variations in IHTT may have cognitive consequences. The second involves conditions under which interhemispheric interaction is necessary and beneficial. The data suggest that when both hemispheres have some competence at a difficult task, there is a benefit to interhemispheric interaction. The role of the CC in the dynamic distribution of attention may be particularly relevant to this advantage. Throughout the article reference is made to individual differences and developmental changes associated with interhemispheric interaction.

Animals↗